Vinzix solution 20mg/2ml Vinphaco treatment of edema in congestion heart failure (10 blisters x 5 tubes x 2ml)

Dosage form Box of 10 blisters x 5 tubes x 2ml
Specifications Furosemide

Ingredient

Thành phần cho 2ml

Composition information	Content
Furosemide	20mg

Uses

indications

Vinzix medicine 20mg/2ml is indicated in the following cases:

Treatment of edema in congestive heart failure, kidney disease and cirrhosis.

Support the treatment of acute pulmonary edema, hypertension.

Treatment of hypertension, especially when caused by congestion or kidney failure. (However, the use of strong diuretics like Furosemid can cause anemia in the brain. So do not use to treat hypertension for the elderly).

Pharmacology

Code ATC: C03CA01

Furosemid is a diuretics that conducts sulfonamid diuretic belonging to a strong, fast, dosage -dependent effect group. The drug acts on the upward branch of the Henle straps, so it is classified as a group of diuretics. The main mechanism of action of Furosemid is to inhibit the co-transport system Na+-K+-2Cl- at the thick segment of the branch to the Henle straps, increasing the excretion of these electrolytes, accompanied by increased water export exercises. The drug also reduces the reabsorption of Na+, Cl- and increases the excretion of K+ in the distance and can work directly on the nearby tube. Furosemid does not inhibit the anhydrase carbon dioxide and non -antagonistic with aldosteron. Furosemid increases the elimination of Ca2+, Mg2+, hydrogen, ammonium, bicarbonate and maybe even the kidney phosphate. Losing a lot of potassium, hydrogen and chlorine can cause metabolic alkali. Due to reducing plasma volume, it can cause hypotension but usually only mitigate.

Furosemid has the effect of renal vasodilation, reducing the impact of the kidney and blood flow through the kidney after taking the drug. In patients with congested heart failure with acute myocardial infarction, after furosemid intravenous injection, glomerular filtration power increases temporarily but significantly, while reducing peripheral veins and increasing peripheral venous blood. When taking high doses in patients with chronic renal impairment, the filtration rate of the glomeruli may increase temporarily. If the urinary tract is excessive due to the drug that reduces the vol

Furosemid is less acting on blood glucose levels than thiazid, but it can cause hyperglycemia, urinary glucose and glucose tolerance, which can be the result of hypotension.

Dynamic pharmacokinetics

When intravenous injection, the effect of the drug appears after about 5 minutes, reaching the maximum within 20 - 60 minutes and lasts about 2 hours. It is unknown the drug concentration needed in the serum to achieve maximum diuretic benefits, but the level of response is not correlated with the peak concentration or the average concentration of the drug in the serum. In people with severe kidney failure, the diuretic benefits may be prolonged.

up to 99% of blood furosemids attached to plasma albumin. The free (non -mounted) Furosemid part is higher in people with heart disease, kidney failure and cirrhosis. Furosemid is excreted mainly through urine, largely in the form of non -metabolic. The sale time is from 30 to 120 minutes in normal people, prolonged in infants and patients with liver and kidney failure.

Furosemid passes through the placenta and distributed into breast milk. The clearance of Furosemid does not increase when hemolysis.

Before taking Vinzix solution 20mg/2ml Vinphaco treatment of edema in congestion heart failure (10 blisters x 5 tubes x 2ml)

How to use

intravenous or intravenous injection when it is necessary to start diuretic effect quickly or when the patient cannot drink.

When intravenous injection, must be injected slowly for 1-2 minutes. Use oral by oral as soon as possible. When intravenous intravenous injection or intravenous infusion, the speed does not exceed 4 mg/min in adults. For intravenous transmission, dilute Furosemid in 0.9%sodium chloride solutions, Ringer Lactac or 5%Dexerrose, adjust the pH greater than 5.5 when needed.

Dosage

Supporting treatment

Adults:

conventional dose intramuscularly or intravenously 20 - 40 mg, a single dose. If not responded to the first dose, the second dose and each next dose may increase by 20 mg, but not for 2 hours earlier, until the desired diuretic meets. After that, the effective single dose can give 1-2 times daily.

To treat acute pulmonary edema in adults, it is possible to have an intravenous injection of 1-2 minutes by 40 mg. If within 1 hour does not see the effect, the dose can be increased to 80 mg intravenously for 1-2 minutes.

In adults with hypertension, normal renal function, can be intravenous in 1-2 minutes of 40 - 80 mg of Furosemid (along with other blood pressure loss drugs); If the kidney function decreases, may need higher doses.

Children:

To treat acute pulmonary edema or congestive or kidney failure, the normal starting dose is 1 mg/kg intramuscularly or intravenously. If necessary, for non -response cases, the dose may increase by 1 mg/kg but not for 2 hours earlier, until the desired effect is achieved. Usually the dose of 1 mg/kg has been satisfactorily responded, rarely to use 2 mg/kg. The maximum injection dose for children is 6 mg/kg/day. However, such high doses have many potential risks.

Hypercalcemia treatment

Adults:

Severe cases, intravenous injection 80 - 100 mg, repeat if necessary after every 1-2 hours. If the level is lighter, the dose may be smaller, 2-4 hours away.

Children:

Intramuscular or intravenously 25 - 50 mg, if needed, it can be repeated, 4 hours apart until satisfactory.

Elderly:

may be more sensitive to the effect of the drug.

High -dose therapy

high -dose Furosemid used for supplementary treatment for other therapy to treat acute or chronic renal failure, including peritoneal or artificial kidney. In some patients, Furosemid may delay the demand for appraisal, increase the distance to be fertilized, shorten the time of hospitalization or allow the water to put water into the body a little more free.

Treatment of urinary tract - anuria in acute or chronic renal failure

When the glomerular filtration level is less than 20 ml/min, take 250 mg of diluted Furosemid in 250 ml of appropriate infusion such as 0.9%sodium chloride, ringer lactate, dexerrose ... transmitted for an hour. If diuretic effects have not met an hour after the transmission of the dose can increase to 500 mg phase with the appropriate number of transmission and the transmission time is about 2 hours. If the diuretic effect is not satisfactory 1 hour after the second end, then the third dose: 1 gram of Furosemid is continued in 4 hours, the transmission speed does not exceed 4 mg/min. If the maximum dose of 1 gram of intravenous infusion does not work, the patient needs artificial dialysis.

It is possible to repeat the effective dose after 24 hours, after which the dose must be adjusted according to the response of the patient.

Treatment of chronic kidney failure

Initial dose: 250 mg. When needed, you can add 250 mg every 4 hours, maximum: 1.5g/24 hours, special cases can be up to 2g/24 hours. Adjust the dose depending on the response of the patient. However, not long -lasting.

While using high -dose Furosemid therapy, it is necessary to check for water -electrolyte monitoring. Especially in shocked people, blood pressure and blood volume must be measured to adjust before starting this therapy. This high -dose therapy is contraindicated in renal failure due to toxic drugs for kidney or liver and in renal failure in combination with liver coma.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when using overdose?

Expression:

Dehydration, reduced blood volume, hypotension, electrolyte imbalance, hypokalemia, alkaline infection.

Management:

In return, the amount of water and electrolytes has been lost. Check regularly in serum, carbon dioxid and blood pressure. Must ensure adequate drainage in patients with congestion of urine from the bladder (such as prostate hypertrophy). Hematoparoa does not increase Furosemid excretion.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using Vinzix 20mg/2ml medicine, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Circulation: Reduce blood volume in case of high dose treatment. Lower blood pressure.

Metabolism: Water and electrolyte imbalance include hypokalemia, hypoglycet hypoglycemia, hypoxemia, blood calcium loss, alkaline infection.

Uncommon, 1/1000

Digestive: Nausea, vomiting, digestive disorders.

Metabolism: hyperuricemia and gout.

Rare, ADR

Skin: skin rash, paresthesia, urticaria, itching, hemorrhage, peeling dermatitis, sensitive reaction to light (may be serious).

Hypersensitivity reactions: Vascular inflammation, interstitial nephritis, fever.

Blood: Inhibit bone marrow, leukopenia, thrombocytopenia, granulocytosis, anemia.

Metabolic: Hyperglycemia, urinary glucose (may be less than the durian benefits). Pancreatitis and jaundice (more than thiazid).

ears: tinnitus, hearing loss, deafness (especially when high doses, fast speed). Deafness may not recover, especially in patients taking the same drugs that are also toxic to ears.

Instructions on how to handle ADR

Check regularly electrolytes. Supplement potassium or use with diuretics to keep potassium when the patient is at higher risk of hypokalemia. Avoid intramuscular injection or intravenous injection quickly and exceeding the usual dose of 20 - 40 mg treatment to reduce the risk of tinnitus, hearing loss, deafness.

Dose reduction or stop treatment if ADR is medium or severe.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

Vinzix medicine 20mg/2ml contraindicated in the following cases:

sensitive to any ingredient of the drug.

Hypersensitivity to Furosemid and sulfonamid derivatives, such as sulfamid cure diabetes.

Reduce blood volume, dehydration, severe hypotension, severe hypoglycemia. The situation of liver coma, liver coma with cirrhosis.

Animal or renal failure due to toxic drugs with kidneys or liver.

Be cautious when using

monitor electrolytes, especially potassium and sodium, hypotension, gout, diabetes, kidney failure, liver failure. Avoid use in patients with severe liver failure. Reduce the dose in the elderly to reduce the risk of toxicity with hearing. When the urine is small, it is necessary to compensate for the blood volume before taking the drug.

Be cautious when using Furosemid in children, especially when used for prolonged use. Careful monitoring of water and electrolytes must be monitored. Babies lacking monthly when using Furosemid may be at risk of getting diseases and arterioscleros. Furosemid occupies the place of bilirubin at the albumin -mounted position, must be used cautiously in children with jaundice. Furosemid's clearance in newborns is much slower than adults, the half -life of plasma is 8 times longer, which must be calculated when using the dose to repeat.

Intravenous speed does not exceed 4 mg/ minute, slower in patients with renal impairment, liver syndrome or liver failure.

Be cautious for patients with prostate hypertrophy or urination because it can promote urinary retention. Using Furosemid is considered unsafe in patients with porphyrin metabolic disorders because it is often accompanied by an exacerbation.

In patients with parathyroid hygiene, using Furosemid may cause muscle spasms (tetani) due to hypocalcemia.

The ability to drive and operate machinery

The drug can cause unwanted effects such as headache, hypotension, dizziness, dizziness. So do not drive, operate machinery or work on high when encountered unwanted effects of the drug.

Pregnancy

Furosemid may affect the fetus due to reducing the mother's blood volume.

Animal studies found that Furosemid could cause miscarriage, fetal death and mother without explaining. There is evidence of water stasis that occurs in pregnancy when the mother is treated with Furosemid. There are not enough well -controlled and complete studies in pregnant women, so only use Furosemid during pregnancy when the benefits are greater than the risk of pregnancy.

breastfeeding period

using Furosemid during breastfeeding is at risk of inhibiting milk secretion. Should stop breastfeeding if taking the drug is necessary.

Interactive drug

Other diuretic drugs: increase the effect of Furosemid. Potassium -keeping pills can reduce potassium loss when using Furosemid (beneficial).

Antibiotics: Cephalosporin increases the toxicity of the kidneys, aminoglycosides increase toxicity to the ears and kidneys, Vancomycin increases the toxicity of the ear.

Lithi salt: increases the level of lithium in the blood, can be toxic. Should avoid using if you do not track tight blood lithium concentration.

cardiac glycosides: increases the toxicity of glycosides on the heart due to furosemids that lower blood potassium. Need to monitor blood potassium and electrocardiograms.

Non -steroid anti -inflammatory drugs: increases the risk of toxicity to the kidneys, reducing diuretic effects.

corticosteroid: Increased risk of reducing potassium, antagonism with diuretic effects.

Anti -diabetic drugs: reduce the effect of lowering blood glucose of anti -diabetic drugs. Need to monitor and adjust the dose.

Non -reducing muscle relaxants: increase muscle relaxation effect.

Anticoagulants: Increasing anticoagulant effects.

cisplatin: Increases toxicity to ears and kidneys.

Hemotrogate medications: increase the effect of lowering blood pressure. If coordinated, the dose should be adjusted. Especially when combined with enzyme inhibitors Angiotensin transfer, blood pressure may decrease/severe.

Anti -epileptic drugs: Phenytoin reduces the effect of Furosemid, carbamazepine reduces sodium blood pressure.

Chloral Hydrate: causes blushing syndrome, tachycardia, hypertension, sweating.

Probenecid: Reducing the renal clearance of Furosemid and reducing the diuretic effect.

Central neurological inhibitors (Clopromazin, Diazepam, Clonazepam, Halothan, Ketamin): Increases the effect of reducing blood pressure.

Cavalry

Injecting Furosemid solution is a mild alkaline solution, not mixed or diluted in glucose solution or acid solution, not combined with any drug in infusion or syringe containing Furosemid.

Storage

In a dry place, temperatures below 30 ° C, avoid light.

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